HESI RN EXIT EXAMS V1, V2, V3, V4,
V5, V6
EXAM
Safe & Effective Care Environment / Management of Care
1. A charge nurse is making assignments for a medical-surgical unit. Which client
should be assigned to the most experienced RN?
A) Client with pneumonia requiring IV antibiotics every 6 hours
B) Client 2 days post-appendectomy with a draining wound
C) Client newly diagnosed with diabetic ketoacidosis on an insulin drip
D) Client with chronic kidney disease receiving hemodialysis
Correct Answer: C
Rationale: A client in DKA on an insulin drip is hemodynamically unstable, requires
frequent blood glucose monitoring, electrolyte replacement, and complex titration of
insulin. This unstable client requires the most experienced RN.
2. A nurse is supervising a licensed practical nurse (LPN). Which task should the RN
delegate to the LPN?
A) Perform the initial admission assessment on a client with pneumonia
B) Administer IV push morphine to a client reporting 8/10 pain
C) Insert a Foley catheter for a client with urinary retention
D) Create the nursing care plan for a newly admitted stroke client
,Correct Answer: C
Rationale: Inserting a Foley catheter is within LPN scope of practice in most states when
competency is validated. Initial assessment, IV push medications, and care plan creation
are RN responsibilities.
3. A client tells the nurse, "I don't want the surgery. I've changed my mind." The
surgeon insists the client consented yesterday. What should the nurse do first?
A) Tell the surgeon the client refuses
B) Ask the client to explain their concerns
C) Have the client sign a new consent form
D) Document the refusal and continue pre-op preparation
Correct Answer: B
Rationale: The nurse must first assess the client's understanding and reasons for refusal,
ensuring no coercion or misunderstanding occurred. Client autonomy allows withdrawal
of consent at any time.
4. A nurse notices another nurse administering medication without checking the
client's ID band. What action should the nurse take?
A) Ignore it because the nurse seemed confident
B) Report the observation to the charge nurse
C) Confront the nurse immediately at the nurses' station
D) Document the incident in the client's chart
,Correct Answer: B
Rationale: The nurse has a duty to report unsafe practice. Reporting to the charge nurse
initiates appropriate chain of command and peer review.
5. A hospital is implementing a quality improvement project to reduce catheter-
associated urinary tract infections (CAUTI). Which intervention is most effective?
A) Use sterile technique for all catheter insertions
B) Remove indwelling catheters as soon as possible
C) Use antibiotic-coated catheters for all patients
D) Perform daily meatal care with antiseptic solution
Correct Answer: B
Rationale: The single most effective way to reduce CAUTI is to remove indwelling
catheters as soon as they are no longer clinically indicated. Prolonged catheterization is
the primary risk factor for CAUTI.
6. A charge nurse is evaluating a new graduate RN's performance. Which action by
the new graduate requires immediate intervention?
A) Administering a tuberculin skin test via intradermal injection
B) Documenting a client's allergy to penicillin in the electronic health record
C) Crushing an enteric-coated medication for a client with difficulty swallowing
D) Using two client identifiers before medication administration
Correct Answer: C
Rationale: Enteric-coated medications should never be crushed because the coating
, protects the drug from stomach acid. Crushing destroys this protective mechanism and
can cause gastric irritation or drug inactivation.
7. A nurse is caring for a client with a do-not-resuscitate (DNR) order. The client's
family member asks the nurse to "do everything" if the client's heart stops. What
should the nurse do?
A) Follow the family member's request
B) Explain the DNR order and notify the healthcare provider
C) Call a code if the client's heart stops
D) Ask the family member to leave the room
Correct Answer: B
Rationale: The nurse should explain the DNR order and notify the healthcare provider
so the provider can discuss the family's concerns. DNR orders must be respected unless
formally changed by the provider.
8. A nurse is preparing to administer a blood transfusion. Which action is most
important before starting the transfusion?
A) Check the client's vital signs
B) Verify the blood product with another licensed nurse
C) Obtain informed consent from the client
D) Prime the tubing with normal saline
Correct Answer: B
Rationale: Verification of the blood product with another licensed nurse (two-nurse
V5, V6
EXAM
Safe & Effective Care Environment / Management of Care
1. A charge nurse is making assignments for a medical-surgical unit. Which client
should be assigned to the most experienced RN?
A) Client with pneumonia requiring IV antibiotics every 6 hours
B) Client 2 days post-appendectomy with a draining wound
C) Client newly diagnosed with diabetic ketoacidosis on an insulin drip
D) Client with chronic kidney disease receiving hemodialysis
Correct Answer: C
Rationale: A client in DKA on an insulin drip is hemodynamically unstable, requires
frequent blood glucose monitoring, electrolyte replacement, and complex titration of
insulin. This unstable client requires the most experienced RN.
2. A nurse is supervising a licensed practical nurse (LPN). Which task should the RN
delegate to the LPN?
A) Perform the initial admission assessment on a client with pneumonia
B) Administer IV push morphine to a client reporting 8/10 pain
C) Insert a Foley catheter for a client with urinary retention
D) Create the nursing care plan for a newly admitted stroke client
,Correct Answer: C
Rationale: Inserting a Foley catheter is within LPN scope of practice in most states when
competency is validated. Initial assessment, IV push medications, and care plan creation
are RN responsibilities.
3. A client tells the nurse, "I don't want the surgery. I've changed my mind." The
surgeon insists the client consented yesterday. What should the nurse do first?
A) Tell the surgeon the client refuses
B) Ask the client to explain their concerns
C) Have the client sign a new consent form
D) Document the refusal and continue pre-op preparation
Correct Answer: B
Rationale: The nurse must first assess the client's understanding and reasons for refusal,
ensuring no coercion or misunderstanding occurred. Client autonomy allows withdrawal
of consent at any time.
4. A nurse notices another nurse administering medication without checking the
client's ID band. What action should the nurse take?
A) Ignore it because the nurse seemed confident
B) Report the observation to the charge nurse
C) Confront the nurse immediately at the nurses' station
D) Document the incident in the client's chart
,Correct Answer: B
Rationale: The nurse has a duty to report unsafe practice. Reporting to the charge nurse
initiates appropriate chain of command and peer review.
5. A hospital is implementing a quality improvement project to reduce catheter-
associated urinary tract infections (CAUTI). Which intervention is most effective?
A) Use sterile technique for all catheter insertions
B) Remove indwelling catheters as soon as possible
C) Use antibiotic-coated catheters for all patients
D) Perform daily meatal care with antiseptic solution
Correct Answer: B
Rationale: The single most effective way to reduce CAUTI is to remove indwelling
catheters as soon as they are no longer clinically indicated. Prolonged catheterization is
the primary risk factor for CAUTI.
6. A charge nurse is evaluating a new graduate RN's performance. Which action by
the new graduate requires immediate intervention?
A) Administering a tuberculin skin test via intradermal injection
B) Documenting a client's allergy to penicillin in the electronic health record
C) Crushing an enteric-coated medication for a client with difficulty swallowing
D) Using two client identifiers before medication administration
Correct Answer: C
Rationale: Enteric-coated medications should never be crushed because the coating
, protects the drug from stomach acid. Crushing destroys this protective mechanism and
can cause gastric irritation or drug inactivation.
7. A nurse is caring for a client with a do-not-resuscitate (DNR) order. The client's
family member asks the nurse to "do everything" if the client's heart stops. What
should the nurse do?
A) Follow the family member's request
B) Explain the DNR order and notify the healthcare provider
C) Call a code if the client's heart stops
D) Ask the family member to leave the room
Correct Answer: B
Rationale: The nurse should explain the DNR order and notify the healthcare provider
so the provider can discuss the family's concerns. DNR orders must be respected unless
formally changed by the provider.
8. A nurse is preparing to administer a blood transfusion. Which action is most
important before starting the transfusion?
A) Check the client's vital signs
B) Verify the blood product with another licensed nurse
C) Obtain informed consent from the client
D) Prime the tubing with normal saline
Correct Answer: B
Rationale: Verification of the blood product with another licensed nurse (two-nurse
